Urgency tied to poorer quality of life, ups hospitalization risk in UC patients

Urgency, or the immediate need to defecate, in patients with ulcerative colitis (UC) is an independent predictor of compromised quality of life (QoL) and future risk of hospitalizations, corticosteroid use, and colectomy, suggests a study.

A cross-sectional and subsequent longitudinal study was conducted within Inflammatory Bowel Disease Partners, a patient-powered research network. The authors examined associations of levels of urgency in UC patients with Patient-Reported Outcomes Measurement Information System QoL domains.

A longitudinal cohort analysis was also performed to determine association between baseline urgency and subsequent hospitalization, corticosteroid use, or colectomy for UC within 12 months. Bivariate statistics and logistic regression models were used to describe independent associations.

Overall, 632 UC patients were included in the analysis. Urgency defined as “hurry” (odds ratio [OR], 2.05, 95 percent confidence interval [CI], 1.24‒3.4), “immediately” (OR, 2.76, 95 percent CI, 1.1‒6.74), and “incontinence” (OR, 7.7, 95 percent CI, 1.66‒38.3) increased the possibility of social impairment compared with “no hurry” after adjusting for clinical variables, rectal bleeding, and stool frequency.

In addition, urgency was significantly associated with depression, anxiety, and fatigue, as well as with higher risks of hospitalizations and corticosteroids. On the other hand, “hurry” (OR, 1.42, 95 percent CI, 1.15‒1.75) “immediately” (OR, 1.90, 95 percent CI, 1.45‒2.50) and “incontinence” (OR, 3.69, 95 percent CI, 2.35‒5.80) increased the likelihood of colectomy within 12 months.

“Our findings support the consideration of urgency as a UC-specific patient-reported outcome and its use as an outcome in clinical trials to capture QoL and risk of clinical decompensation,” the authors said.